Read a Q&A about chemical peels with the University of Maryland chief of plastic surgery.
When considering a chemical peel:
It is very important to find a physician who has adequate training and experience in skin resurfacing.
In some states, a medical degree is not required to perform a chemical peel -- even the strongest phenol peels -- and many states have laws that permit non-physicians to administer certain peel solutions, but regulate the strengths which they are permitted to apply.
Chemical peeling uses a chemical solution in order to improve the skin's appearance. It can reduce or eliminate fine lines under the eyes and around the mouth, correct uneven skin pigmentation, remove pre-cancerous skin growths, and soften acne or treat the scars caused by acne. The procedure can also treat wrinkles caused by sun damage and scarring, as well as skin blemishes common with age and heredity. Chemical peels can be performed on the face, neck, chest, hands, arms, and legs.
Possible complications associated with chemical peels:
Change in skin tone color
For certain skin types, there is a risk of developing a temporary or permanent skin color change. Taking birth control pills, pregnancy, or a family history of brownish discoloration on the face may increase the possibility of developing the abnormal pigmentation.
Chemical peels can cause scarring. But, if scarring occurs, it can usually be treated with successful results.
Cold sores and fever blisters
Those who are susceptible to cold sores or Herpes simplex infections may see a reactivation of cold sores or fever blisters following a chemical peel.
Chemical peel is most commonly performed for cosmetic reasons to enhance appearance and self confidence, and may be performed in conjunction with a facelift.
Chemical peel is not a substitute for a facelift, and does not prevent or slow the aging process.
What substances are used for chemical peels?
Alpha hydroxy acids (AHAs), trichloroacetic acid (TCA), and phenol are used for chemical peels. The precise formula used may be adjusted for each specific patient.
Alpha hydroxy Acids (AHAs), such as glycolic, lactic, or fruit acids are the mildest of the peel formulas and produce light peels that can often provide smoother, brighter-looking skin. AHA peels may be used to treat:
- Fine wrinkling
- Areas of dryness
- Uneven pigmentation
- Aid in control of acne
- Smooth rough, dry skin
- Improve texture of sun-damaged skin
AHA peels may cause:
- Crusting, flaking or scaling
Generally, no anesthesia is needed for AHA peels since they cause only a slight stinging sensation during application.
Protecting skin from the sun is important following AHA peels.
Trichloroacetic Acid (TCA) can be used in many concentrations. It is most commonly used for:
- Medium-depth peeling for surface wrinkles
- Superficial blemishes
- Pigment problems
Results of TCA peel are usually less dramatic than, and not as long-lasting as, those of a phenol peel. More than one TCA peel may be needed to achieve the desired result.
TCA-peel patients are advised to avoid sun exposure for several months. It also may produce some unintended color changes in the skin.
It can be used on the neck or other body areas, and may require pre-treatment with Retin-A or AHA creams. It is preferable to a phenol peel for darker-skinned patients.
Anesthesia is not usually required for TCA peels because the chemical solution acts as an anesthetic. Sedation may be used before and during the procedure to help the patient relax. Two or more TCA peels may be needed over several months to obtain the desired result, although mild TCA peels may be repeated more frequently.
Protecting skin from the sun is important following a TCA peel.
Phenol is the strongest of the chemical solutions and produces a deep peel. It is mainly used to:
- Correct blotches caused by sun exposure, birth-control pills, or aging.
- Smooth out coarse wrinkles.
- Remove pre-cancerous growths.
- Should be used on the face only, as scarring may result if used on the neck or other body areas.
- Is not recommended for dark-skinned individuals.
- May pose risk for patients with heart problems.
- May permanently remove facial freckles.
- May cause permanent skin lightening.
- May leave lines of demarcation.
Recovery may be slow and complete healing may take several months.
After a phenol peel, new skin may lose its ability to produce pigment. Skin be lighter in color, and will always have to be protected from the sun.
Phenol may pose a special risk for patients with a history of heart disease.
Protecting skin from the sun is also important following a phenol peel.
About the procedure:
The procedure involves a chemical solution that is applied to the skin. The solution causes a layer of skin to separate and peel off. The new, regenerated skin underneath is usually smoother, less wrinkled, and more even in color than the old skin.